Breast Cancer: Follow-up After Surgery

What is the follow-up after a breast cancer is removed?

After you have finished your treatment for breast cancer, it is very important to discuss any new symptoms or problems with your healthcare provider. Early detection of the cancer, if it comes back, should be a joint effort by you and your provider. This should continue throughout your lifetime.

What happens during follow-up exams?

You will see your healthcare provider (usually your oncologist) about every 4 to 6 months for the first 5 years after breast cancer surgery. At each follow-up visit your provider will check for return of the cancer or spread of the cancer to other parts of your body. A history and physical exam are the most important parts of your care. You may have lab tests.

You should have a mammogram every year. Your provider may not recommend any other X-ray exams unless you have symptoms. If a lump is found, it will be checked very carefully. You may have a biopsy.

After 5 years, depending on how you are doing, your visits will probably be yearly.

What if I am taking tamoxifen or a similar drug?

Tamoxifen is a medicine that may be prescribed for some types of breast cancer. It can stop the hormone estrogen from helping tumors grow. If you are taking tamoxifen or a similar drug, you will need these tests:

• yearly pelvic exam if you still have a uterus
• bone density test

How can I take care of myself?

Stay active and try to keep a healthy weight. Be sure to eat a healthy diet, quit smoking if you are a smoker, and follow an exercise program recommended by your healthcare provider.

Regularly examine your breasts (or breast area if your breasts have been removed). This will help you find any signs that the cancer has come back or that a new cancer has started. Be sure to get a mammogram every year.

Between visits with your healthcare provider, watch for the following signs that the cancer may have come back:

• changes you feel in a breast or in your scar during a breast self-exam, especially thickenings, lumps, redness, pain, or swelling
• long-lasting pain in the shoulders, ribs, hip, back, pelvis, or legs
• loss of appetite or unexplained weight loss or gain
• long-lasting cough

None of these symptoms is a clear sign that the cancer has come back. It is important, though, to report any of these changes to your provider as soon as possible. Do not wait until your next scheduled checkup.

There are many support groups for women who have had breast cancer. These groups can help with emotional concerns and questions after surgery. They can also help with practical things, such as finding comfortable bras and bathing suits. Ask your healthcare provider for information about the group nearest you.

For more information on cancer, contact:

• American Cancer Society, Inc.
  800-ACS-2345 (800-227-2345)
  http://www.cancer.org
• Cancer Information Service
  800-4-CANCER (800-422-6237)
  http://www.cancer.gov/aboutnci/cis